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Our SMC work

A mother helps her child to take SMC medication in Burkina Faso (Credit: Sophie Garcia/Malaria Consortium)
A mother helps her child to take SMC medication in Burkina Faso (Credit: Sophie Garcia/Malaria Consortium)

Across the Sahel region of Africa, most malaria illness and deaths occur during the rainy season from July to October. As mosquitoes breed in water, the rainy season provides the perfect conditions for the population to grow and thereby increase the malaria threat. It is estimated that 29 million children in the region are at risk across the region during this period.

In March 2012, the World Health Organization (WHO) issued a policy recommendation for a new intervention against Plasmodium falciparum malaria in children under five years old in areas where the peak malaria transmission season is no longer than four months: seasonal malaria chemoprevention (SMC).

SMC is a highly effective intervention to prevent malaria in those most vulnerable to the disease’s effects. It involves administering up to four monthly doses of antimalarial drugs to children aged 3–59 months during peak malaria transmission season.

The objective is to maintain therapeutic anti-malarial drug concentrations in the blood throughout the period of greatest risk. This will reduce the incidence of both simple and severe malaria disease and the associated anaemia and result in healthier, stronger children able to develop and grow without the interruption of disease episodes. SMC has been shown to be safe, effective, cost-effective and feasible for the prevention of malaria among children in areas where the malaria transmission season is no longer than four months. Since it was approved by the WHO, SMC has been found to be 75 percent effective in protecting against uncomplicated and severe malaria among children under five. 

An estimated 29 million children across the Sahel region are eligible for SMC. Areas eligible for SMC are those where:

  1. the majority of malaria transmission falls within a short rainy season. The intervention is not suitable for areas where malaria transmission is spread evenly throughout the year.
  2. where resistance to the SMC drugs is low. This means that the current SMC drugs (a combination of sulfadoxine-pyrimethamine and amodiaquine – also called “SPAQ”) can be used in the Sahel, but SMC is unfeasible in areas of seasonal transmission in southern Africa., where SPAQ resistance is common.

Key to the effectiveness of SMC is that distributors and caregivers follow strict guidelines: on the first day of each cycle, a dose of SPAQ should be taken under the supervision of a trained community health worker. On the following two days, caregivers must administer further doses of AQ for maximum protection.

The potential for SMC is enormous — from saving lives and reducing illness to preventing school absenteeism and boosting economic growth. If all children eligible for SMC had access to it, researchers estimate that some 175,000 lives could be saved each year, and 18 million malaria cases prevented.

Now read this: What is Malaria Consortium doing on seasonal malaria chemoprevention?

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